《慎五堂治验录》脑病证治精粹

Key points of diagnosis and treatment of encephalopathy of Shenwutang Zhiyan Lu

文章通过对医案医话的分类整理,归纳总结《慎五堂治验录》脑病证治特点。其所载脑病属广义神志病范畴,与五脏相关;病机以机窍受阻,魂魄不安为关键;重视热邪、伏邪致病;证机要素以热入心营、伏邪异动、土虚(阴亏)失养、风火痰升多见。临证辨治重视清泄热邪、搜剔伏邪、透邪达外,息风化痰、肃清机窍,同时养元扶正、滋水平木、安魂定志,恢复神机功用。脑病证治内涵丰富,特色鲜明,具有典型的世医家范,可作为临床辨证施治的参考。

Summarize the characteristics of syndrome and treatment of encephalopathy in the book Shenwutang Zhiyan Lu through collating the case data.The recorded encephalopathy belongs to the category of abnormal consciousness and behavior,and inseparabled related to the five viscera.The key to the pathogenesis of the disease is that the body is blocked and the‘Hunpo’(soul)is disturbed and pay attention to heat evil and latent pathogen.The main factors of pathogenesis are heat evil entering into the heart camp,abnormal changes of latent pathogen,soil deficiency(yin deficiency)losing nourishment,and wind evil,fire evil and phlegm evil rising.We should pay attention to clearing away heat evil,searching for Fu evil,penetrating evil to the outside,quenching wind and resolving phlegm,and clearing the brain orifices in the clinical treatment of syndrome differentiation.At the same time,nourishing the original qi and nourishing water to moisten wood,make the‘Hunpo’calm to restore the function of the brain is the same important.The syndrome and treatment of encephalopathy is rich in connotation,distinctive in characteristics,and typical of traditional Chinese medicine,which can be used as a reference for clinical syndrome differentiation and treatment.